Abstract：
:Mechanical ventilation has become a very common and well-accepted practice in modern intensive care units. The use of the mechanical ventilator has progressed from being a support system during surgery and for acutely ill patients to being used in both moderate and long-term life support in patients with inadequate ventilation. The sophistication of modern ventilators and the ability of trained respiratory therapists and nursing personnel have permitted this technology to explode. This is occurring at a time when there are still many controversies about the relative benefits and modes of action of conventional ventilation. As newer techniques are developed, it is mandatory that the application of these techniques be tempered with controlled clinical trials, documenting their effectiveness. The beneficial effects of new modalities must be documented as mechanical ventilation expands from use in the intensive care unit to use in standard medical wards and the patient's home. In these latter two settings, the vigilance of an intensive care unit is absent and the simplest method will be preferable. The requirement to demonstrate efficacy of new techniques with adequate studies is especially necessary now as the economics of health delivery have come under increasing scrutiny. Even more important than new technologies may be the efficacy of prolonged mechanical ventilation. A recent study by Spicher and White evaluated the outcome in 250 patients ventilated for 10 days or more at the Hershey Medical Center (Pennsylvania State University). The mortality, morbidity, and disability in patients in this study population requiring prolonged ventilation were extremely high. As these studies have pointed out, further evaluations of predictors of meaningful survival are necessary to avoid unnecessary human suffering and to best use limited resources.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Grum CM,Chauncey JBsubject
Has Abstractpub_date
1988-03-01 00:00:00pages
37-46issue
1eissn
0272-5231issn
1557-8216journal_volume
9pub_type
杂志文章,评审abstract：:This article provides a systematic review of the literature on the application of noninvasive ventilation in various forms of hypercapnic and hypoxemic respiratory failures. A description of the underlying pathophysiology is followed by a review of physiologic data explaining the mechanisms of action of noninvasive ve...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70330-0
更新日期：1996-09-01 00:00:00
abstract：:Delirium is a frequent complication in older patients in the ICU and often persists beyond their ICU stay. Delirium in older persons in the ICU is a dynamic and complex process. There is a high prevalence of pre-existing cognitive impairment in patients who are admitted to the medical ICU. This pre-existing cognitive ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(03)00092-3
更新日期：2003-12-01 00:00:00
abstract：:This article gives a broad overview of the increasingly important applications of bronchoscopy, flexible (FOB) and rigid (RB), in a modern medical intensive care unit. Special emphasis is made to bronchoscopy use in mechanically ventilated patients. Therapies such as endobronchial stenting and Nd:YAG laser are being u...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：10.1016/s0272-5231(05)70041-1
更新日期：2001-06-01 00:00:00
abstract：:Sarcoidosis is a systemic disease with a favorable prognosis, high remission rate, and low mortality. Cardiac involvement alters this prognosis. Clinical manifestations most commonly include arrhythmias, conduction abnormalities, and congestive heart failure. Treatment includes immunosuppressant therapy, permanent pac...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2008.03.005
更新日期：2008-09-01 00:00:00
abstract：:Patient adherence to prescribed tuberculosis regimens must be assured to prevent relapse, acquired resistance, and transmission. Directly observed therapy (DOT), an outpatient management strategy designed to ensure adherence, is not widely used because it is perceived to be inordinately expensive. The primary focus of...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70365-8
更新日期：1997-03-01 00:00:00
abstract：:Bronchodilator therapy with adrenergic agonists in asthma is discussed and the therapeutic efficacy and side effects of various routes of administration of beta agonists are compared. The aerosol administration, the most effective route, is described in detail as to the optimal technique of administration, to the vari...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1984-12-01 00:00:00
abstract：:Each year, a vast number of individuals are infected with the endemic fungi. An expanding population, along with further land development in endemic areas, will likely continue to place individuals at risk for exposure to these organisms. A high index of suspicion may be required to diagnose histoplasmosis, blastomyco...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70232-x
更新日期：1999-09-01 00:00:00
abstract：:This article summarizes the health effects of indoor air pollutants and the modalities available to control them. The pollutants discussed include active and passive exposure to tobacco smoke; combustion products of carbon monoxide; nitrogen dioxide; products of biofuels, including wood and coal; biologic agents leadi...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:As parenchymal lung disease in chronic obstructive pulmonary disease becomes increasingly severe there is a diminishing prospect of drug therapies conferring clinically useful benefit. Lung volume reduction surgery is effective in patients with heterogenous upper zone emphysema and reduced exercise tolerance, and is p...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2013.10.011
更新日期：2014-03-01 00:00:00
abstract：:Prophylaxis for DVT unequivocally is beneficial in patients identified to be at high risk. Heparin prophylaxis with subcutaneous low-dose UFH is adequate in some clinical settings but less effective in others. LMWH preparations are effective and safe as prophylaxis in certain medical patients as well as in general sur...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-06-01 00:00:00
abstract：:This article assesses the role of pharmacotherapy in the management of respiratory muscle dysfunction. It focuses on two classes of drugs, the methylxanthines and the sympathomimetic agents. A prospective section focuses also on the particularities of the diaphragm among the skeletal striated muscles. In addition, a n...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
abstract：:Although a biopsy may need to be performed in complicated patients, bronchoalveolar lavage (BAL) is an important adjunct to the diagnosis of pulmonary and disseminated fungal infections. Culture is the gold standard for diagnosis in many instances, but cytologic and morphologic analysis is often diagnostic. Although n...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2009.02.010
更新日期：2009-06-01 00:00:00
abstract：:Given that poor asthma management leads to such devastating rates of morbidity and mortality in this country, efforts must be made to increase the knowledge, skills, and behaviors of persons with asthma. The suggestions and recommendations provided here represent a blend of academic opinion and practical advice on met...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:A number of different imaging modalities can be used in the assessment of pleural disease. Although ultrasound has been the more traditional method, CT has found increasing utility for the assessment of the empyema and loculated pleural fluid collections prior to drainage and the evaluation of benign and malignant ple...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70076-9
更新日期：1998-06-01 00:00:00
abstract：:Massive hemoptysis is a rare, but life-threatening event. Death from massive hemoptysis is usually due to aspiration of blood. Thus, the initial evaluation should occur simultaneously with efforts to control the patient's airway and respiratory status. Therapeutic interventions can be directed with an understanding of...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-03-01 00:00:00
abstract：:Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniq...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2018.08.002
更新日期：2018-12-01 00:00:00
abstract：:Pulmonary rehabilitation is an art of medical practice incorporating many therapeutic modalities with the goal of improving the patient's functional ability. The gains to be realized and the basis for improvement following pulmonary rehabilitation are detailed in this article. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1986-12-01 00:00:00
abstract：:Bacterial pneumonias occur with increased frequency and can be associated with increased morbidity in the HIV-infected population compared with normals. The pathogens that most frequently cause community-acquired pneumonias are S. pneumoniae, H. influenzae, and occasionally S. aureus. These pneumonias usually respond ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1988-09-01 00:00:00
abstract：:Military personnel can be exposed to toxicants and conditions that can contribute to lung diseases. This article describes what is known about these exposures and diseases, focusing on the Iraq and Afghanistan wars. Adverse lung health outcomes have been reported in US military personnel deployed to Iraq and/or Afghan...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2012.09.001
更新日期：2012-12-01 00:00:00
abstract：:Stents are used for palliation of symptoms of central airway obstruction caused by either malignant or benign conditions. Stents may be applied for maintaining airway patency after dilatation of postinflammatory and infectious strictures, for airway dehiscence after lung transplantation, and for the management of trac...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2009.08.002
更新日期：2010-03-01 00:00:00
abstract：:Pneumonia is an important cause of morbidity and mortality. However, pneumonia is an unusual outcome of respiratory infection. Most of the time, microbes in the lung can be controlled by a combination of constitutive and recruited defense mechanisms. Inflammation is a key component of recruited defenses. Variations in...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2018.07.002
更新日期：2018-12-01 00:00:00
abstract：:Nontuberculous mycobacteria (NTM) are important emerging cystic fibrosis (CF) pathogens, with estimates of prevalence ranging from 6% to 13%. Diagnosis of NTM disease in patients with CF is challenging, as the infection may remain indolent in some, without evidence of clinical consequence, whereas other patients suffe...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2015.11.001
更新日期：2016-03-01 00:00:00
abstract：:Pulmonary function testing (PFT) is used extensively by pulmonary specialists to address two common clinical questions: (1) What is the risk of a postoperative pulmonary complication in an individual with lung disease? and (2) Will the patient be able to tolerate lung resection surgery? Today, there are numerous tests...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70061-7
更新日期：2001-12-01 00:00:00
abstract：:Both chylothorax and pseudochylothorax are characterized by milky or turbid pleural effusions. The importance of distinguishing these two conditions cannot be overemphasized because the prognosis and management are different. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:In the past 3 years, lung volume reduction surgery has become the most controversial topic in the clinical management of patients with emphysema. Although literature has added to the understanding of the procedure, many important issues remain unclear. This article emphasizes functional and basic physiologic changes t...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70377-4
更新日期：1997-06-01 00:00:00
abstract：:In the past it was believed that respiratory disability could be objectively assessed by comparing the measured O2 consumption requirement of the job with the subjects' measured or estimated maximal oxygen consumption. More recently, it has become clear that this "classic" paradigm does not completely apply to all sit...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Anticholinergic agents are useful bronchodilators, the use of which should not be overlooked in patients with airways diseases. In patients with stable asthma, they are not first-line therapy but may be valuable as adjunctive therapy. In status asthmaticus they add to the bronchodilatation achieved by adrenergic thera...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
abstract：:Systemic lupus erythematosus (SLE) is a potentially severe, frequently disabling autoimmune disease with multiorgan involvement and a typically waxing and waning course. SLE is often considered the prototypical autoimmune disease. Although SLE has the potential to affect any organ, the lungs are commonly involved late...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2010.05.001
更新日期：2010-09-01 00:00:00
abstract：:The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared. Small percentages...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：:Because the AIDS epidemic continues to grow, there is a sense of urgency to develop new treatment strategies, both for HIV infection and for AIDS-related illnesses. The rapid gathering of basic information related to HIV type 1 biology and opportunistic infections has led to an explosion in physicians' ability to diag...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70338-5
更新日期：1996-12-01 00:00:00
